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Objective . To summarize the characteristics and analysis of relevant factors and to give references for prevention and further study of liver damage associated with  Polygonum multiflorum  Thunb. (HSW), we provide a systematic review of case reports and case series about liver damage associated with HSW.  Methods . An extensive search of 6 medical databases was performed up to June 2014. Case reports and case series involving liver damage associated with HSW were included.  Results . This review covers a total of 450 cases in 76 articles. HSW types included raw and processed HSW decoction pieces and many Chinese patent medicines that contain HSW. Symptoms of liver damage occur mostly a month or so after taking the medicine, mainly including jaundice, fatigue, anorexia, and yellow or tawny urine. Of the 450 patients, two cases who received liver transplantation and seven who died, the remaining 441 cases recovered or had liver function improvement after discontinuing HSW products and conservative care.  Conclusion . HSW causes liver toxicity and may cause liver damage in different degrees and even lead to death; most of them are much related to long-term and overdose of drugs. Liver damage associated with HSW is reversible, and, after active treatment, the majority can be cured. People should be alert to liver damage when taking HSW preparations.

Liver Damage Associated withPolygonum multiflorumThunb.: A Systematic Review of Case Reports and Case Series